Andrew Lansley: the strength of feeling shows why we had to listen

Readers of HSJ will need no reminding that the NHS Future Forum recently published its recommendations on the Health and Social Care Bill. Nor that parliamentary scrutiny has begun on its amendments.

From the very beginning of the bill’s passage through parliament, and even when I was in opposition, I was clear that empowerment should be ingrained into any reform of the NHS. So, based on the Future Forum’s report, we have boosted our plans to make sure that doctors and other health professionals are given the freedom, trust and resources to make decisions for their patients.

I want to see GPs working with their colleagues across the NHS, taking charge of commissioning and making decisions as close to patients as possible. So the services available to communities are effective and, just as importantly, relevant.

The NHS Commissioning Board will keep the outcomes framework at the centre of everyone’s thinking. It will make sure clinical commissioning groups are able to assume commissioning and budgetary responsibilities at a speed that is right for them. And then, after they are up and running, it will make sure they are all performing at their maximum potential.

Those of you who followed the listening exercise will be aware of the strength of feeling about the importance of diverse clinical leadership.

I want to be certain the whole spectrum of clinical professions is able to contribute to all stages of the commissioning process. That is why I have made sure clinical networks will be strengthened in the new system. I know their expertise and experience is vast, so they will provide leadership on their specific areas of healthcare.

Complementing clinical networks will be clinical senates, which will provide individualised advice on how to integrate care and consistently get the best health outcomes for patients.

The Future Forum recommended a much stronger focus on how to secure more integrated services for patients. That is why clinical commissioning groups will now have a duty to help bring health and social care services together. I want to see a system where every service offered by the NHS – whether it is physiotherapy, re-ablement, social care, phlebotomy, or anything else – fits together like a jigsaw for every single patient that comes through our doors. And I will look to the commissioning board to lead by example.

I have also been clear about the need for commissioners to be open and transparent. That need is already set out in law, but I think that law should be a bare minimum. It is not good enough to simply hold meetings in public and publish minutes. On top of that, there must be a wider culture of openness, adopted fully by clinical commissioning groups and the commissioning board.

I want to see these changes brought in as quickly as possible, but with measures taken to avoid any teething problems. With that in mind, the timescales for the new arrangements have changed. By April 2013, all GP practices will be members of either an authorised clinical commissioning group or a shadow commissioning group. Groups that are ready will be able to take on full budgetary responsibility by the same time. Those practices that are not ready will be offered a helping hand by the commissioning board, which will commission services on their behalf and hand over commissioning responsibility as soon as they are able to take it on.

In debates about the new commissioning system, there is much talk of organisations, names and structures. But when we talk about the NHS progressing, working tirelessly for patients, we are talking about people. About patients and carers, about doctors, nurses and countless other professional groups, but also about the managers and leaders who are an essential part of any high functioning healthcare system. The future of the NHS requires not just retaining the best management and leadership, but providing them with the ongoing training and development they need to carry on getting better.

We have listened to clinicians, patients and the NHS Future Forum to get all these changes right. Now it’s over to you. You and your colleagues can take our plans forward locally, using them to take greater ownership of your local NHS and make sure all your patients see the benefit.